RHEUMATOID ARTHRITIS AND COMORBID PERIODONTITIS: CLINICAL AND PATHOGENETIC FEATURES OF RELATIONS
Summary. Relevance. Comorbid periodontitis aggravates a systemic immune inflammation in rheumatoid arthritis (RA), sensitiveness to autoantigenes. RA and periodontitis may be associated with osteoclase, allelic genes, and zagalny imbalance in the form of cytokine fissures, altogether the pathogenetic mechanisms of the need for additional vivification. The purpose and objectives of the study: to understand the specialties of the RA on such comorbid periodontitis, because of the role of the ash microbial in the pathogenetic motives of both diseases, assessment of the power of the oral life in the case of parodontitis. Materials and methods. 173 patients with RA were observed. To assess the number of microorganisms on the mucous membrane of the gums, the method of sterile paper discs was used. Physicochemical adsorption-rheological properties of oral fluid, levels of proinflammatory cytokines, concentrations of individual fractions of MMM were studied. Results. Periodontitis was diagnosed in 46% of RA patients, the development of which was closely related to the activity and stage of the joint syndrome, the presence of systemic osteoporosis, seropositivity for rheumatoid factor and antibodies to cyclic citrulline peptide. An increase in the concentration of pro-inflammatory cytokines in the oral fluid, an increase in the level of MMM of all fractions, which is associated with the severity of the course and joint syndrome, and periodontitis, features of the gingival microbiota. Conclusions. The obtained data testify to the common pathogenetic structures of RA and comorbid periodontitis, substantiate the possibility of developing new approaches to individual pathogenetic therapy of RA taking into account the etiology of background oral pathology, assessment of inflammatory activity, predicting the nature of the disease and treatment effectiveness.
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